Lauren Marie Rackovan

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

2018030932 Issued in MO

Practice address

1011 Bowles Ave Ste 215
Fenton, MO 63026-2387

Phone

(636) 680-1960

NPI assigned

Apr 4, 2019

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Mercy Clinic East Communities

  • Internal Medicine Physician
  • Saint Louis, MO
  • NPI 1851335228
  Medicare reassignment
• Missouri Center for Reproductive Medicine, LLC

  • Reproductive Endocrinology Physician
  • Chesterfield, MO
  • NPI 1487076485
  NPD (past)
• New Fino LLC

  • Ambulatory Fertility Facility
  • Mandeville, LA
  • NPI 1558027201
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1554336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554336000000",
    "number": "1508328782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "517 QUEENS COURT PL",
            "city": "SAINT PETERS",
            "state": "MO",
            "postal_code": "633767390",
            "telephone_number": "636-699-8743"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1011 BOWLES AVE STE 215",
            "city": "FENTON",
            "state": "MO",
            "postal_code": "630262387",
            "telephone_number": "636-680-1960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RACKOVAN",
        "first_name": "LAUREN",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-04",
        "last_updated": "2019-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MO",
            "license": "2018030932",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emily Rose Prost
• Daniel Gerard Puetz, O.D.
• Kristen Anne Puff, DNP, AGACNP-BC
• Kristopher Vaughn Pullam, MD
• Heather M Quist, FNP-C
• Vivi Y Radtke, OTR/L
• Amira Rajih
• Valerie Marie Rasche, PA
• Kristy Lea Ratkowski, MD
• Kelly Ratz, MSN-FNP

• Obstetrics & Gynecology Physician in Fenton, MO
• Providers in Fenton, MO by specialty
• Obstetrics & Gynecology Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.